If you are in the market for an Independent Review Organization (IRO) partner, looking for an IRO that is accredited is a great first step. Accreditation ensures that you receive the highest quality in service and support as well as an IRO who follow strict federal and state regulations. Accredited IROs must comply with important federal and state standards and timelines, ensuring you receive quality support that will help you create efficiencies for your peer review program.

Choosing the right Peer Review Program can be difficult. It’s important to look for a Peer Review Program that distinguishes itself through quality work, ongoing training, full compliance, and the latest technology. You want to trust the organization you choose and make sure they are industry certified. Use these 5 tips to help you choose a Peer Review Program or use as a guide for your current vendor.

Peer-to-Peer and Physician Advisory Review Programs are a crucial part of driving quality improvement throughout healthcare organizations. They are key to helping organizations maintain credibility and support effective unbiased reviews. Thanks to the Affordable Care Act, consumers expect unbiased review of their care through the claims and appeals processes. Independent Review Organization have now been placed in the forefront of the healthcare industry.

Not all Peer Review Programs are equal. Therefore, it’s important you understand the differences from one program to another, as these differences can determine the efficiency and effectiveness in how your claims process operates. Your Peer Review vendor should be a perfect fit for your organization and if you have any reservations about the progress and efficiently of your peer review program, it may be time for a different vendor. By arming yourself with the correct knowledge to make educated decisions, you will be able to forge a successful partnership.

BHM's webclinic “Components of a Great Peer Review Program” goes live Wednesday, November 18th from 12:00pm to 1:00pm EST. You don't want to miss this great opportunity to receive expert advice related to Peer Review Services. Don't worry you still have time to sign up!

Lately we have been talking about the important of Independent Review Organizations (IROs) and peer reviews in the healthcare ecosystem. Today we continue this discussion and delve deep into the importance of the peer review process. We know that peer reviews are a crucial part of healthcare because they hold medical professionals and organizations accountable in addition helping to build a world of trust between patient and physician. The peer review process is one that consists of high levels of property technology and superior customer service. By boosting transparency in healthcare, peer reviews have become an essential standard helping to make healthcare safer and more efficient. So let’s take a look at the 5 core building blocks of the peer review process.

If you think you might need an Independent Review Organization to provide unbiased peer reviews in a manner that complies with all federal and state regulations, BHM can help. Last week we talked about the top 5 reasons you might need an external IRO but this week we’re focusing on the real-life situations that might lead to you to hire an IRO. If your answer to any of these questions is “yes," you may want to look into hiring an IRO.

Peer reviews are an essential part of healthcare in that they not only hold medical entities accountable, but they also provide valuable resources for learning and evaluation. It also helps foster a foundation of trust between patients and physicians by ensuring fairness is guaranteed for everyone. When the transparency of peer reviews is put to work as a tool, a paradigm shift happens--and standardized metrics give providers across the board access to information that helps make healthcare safer, more efficient, and more effective.

"BHM provides consultation and direct clinical oversight to East Carolina Behavioral Health as a delegated authority for clinical peer review and physician services. We have been extremely satisfied, and value the organization’s depth and breadth of knowledge. BHM continues to exceed our expectations."

Cindy Ehlers,
V P Clinical Operations, Trillium (formerly ECBH)

"6 of the top 10 largest health plans* entrust BHM for behavioral health peer reviews.